CC-0503-2022 Office Use Only
ADDITION/ALTERATION PERMIT Permit#: C.C.'CFJd3 20 2-2
Town of APPLICATION Permit Fee: $ 2t . bO
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.queensburv.net Invoice#: 2453
Flood Zone? Y ReviewecrBy:
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Project Location: 37 Homer Ave.
Tax Map ID #: 302.8-2-5 Subdivision Name: IE C Li D W I
PROJECT INFORMATION: AUG 1 2 2022 J
TOWN OF QUEENSBURY
BUILDING&CODES
TYPE: El Residential ❑ Commercial, Proposed Use: '
❑ Single-Family ❑ Two-Family El Multi-Family(#of units_) ❑ Townhouse
❑ Business Office El Retail El Industrial/Warehouse ❑ Garage (#of cars
111 Other (describe Place of Worship (existing) ) .
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor: 627.5 sf
2nd floor: 2nd floor:
3rd floor: 3rd floor:
Basement (habitable space): Basement (habitable space):
Total sq ft: Total sq ft: 627.5 sf
Scope of work to be done: Demolition of a portion of the existing stage, ramp and stairs. New
construction of extended stage and relocated ramp. Infill of existing
exterior door. Upgrades to A/V system.
Addition/Alteration Application Revised June 2022
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$ 15,000-$20,000
2. Source of Heat(circle one): Gas ❑ Oil 0 Propane ❑ Solar 0 Other:
Fireplaces/inserts need a separate Fuel Burning Appliances&Chimney Application
3. Are there any structures not shown on the plot plan? 0 YES ® NO Explain:
4. Are there any easements on the property? ❑YES IN NO
SITE INFORMATION:
• Is this a corner lot? •YES 0 NO
• Will the grade be changed as a result of the construction? ❑YES . NO
• What is the water source? ■PUBLIC ❑ PRIVATE WELL
• What type of wastewater system is on the parcel? II SEWER ❑ PRIVATE SEPTIC
DECLARATION:
1. I acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period.Any changes to the approved plans prior to/during construction will require
the submittal of amended plans,additional reviews and re-approval.
2. If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of
Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
3. If the work is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. I certify that the application, plans and supporting materials are a true and a complete statement and/or description
of the work proposed,that all work will be performed in accordance with the NYS Building Codes,local building laws
and ordinances, and in conformance with local zoning regulations.
5. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: %lir gel/ gosr,�
SIGNATURE: (�� r% _j ?�---� DATE: S /S 2z
Addkion/Alteration Application Revised June 2022
� � FIRE MARSHAL'S OFFICE
.i 11. Town of Queensbury
742 NY 12804
Bay Road, Queensbury,
— "Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Northway Christian Family Church
37 Homer Avenue
JcOP 9/16/2022
The following comments are based on a review of submittals:
• Add fire extinguisher at new exit
• Locks /Latches to comply with Chapter 10 of IFC
• Make sign above new exit door combo pak (exit and Emergency lighting)
1\1\c\,e
Michael J Palmer
Fire Marshal
742 Bay Road
Queensbury NY 12804
firemarshal@queensbury.net
Fire Marshal 's Office • Phone: 518-761-8206 • Fax: 518-745-4437
firemarshal@queensbury.net • www.queensbury.net
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